Last chemo treatment put me in hospital

Posted by relicmeister @rselicmeister, Sep 28, 2024

Had a very positive oncology consult which was to review the PET scan done 2 days earlier. While he couldn’t access it yet, my bloodwork revealed extremely good numbers including near normal cancer markers. So good, he said he fully expected a good PET scan report. Off I go to treatment upped to 80% oxaliplatin from 50%. Fine. Woke that evening extremely ill and out of it with asthma symptoms also. Wound up at the ER next day but never left. My BP was so low they considered putting me in the ICU and had potent meds to bring mean arterial pressure up. Now it’s day 4 - broad band IV antibiotics due to fever, in isolation-telemetry room , x-rays, cat scans, cultures, nebulizer treatments. All the time feeling sicker than any time of my life. Began coughing sputum with blood flecks which could be from severe irritation of windpipe.
Bottom line hypothesis is an acute chemo reaction with infection somewhere that is now under control. Stearoid and breathing treatments are starting to help the asthma like symptoms and I’ve had first bite of food in 4 days plus on the enteric pump.
I believe I’ve turned a corner and will go home tomorrow or Monday.

I guess they might have to modify my chemo formula to avoid such a terrible reaction in future rounds.

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@rselicmeister

Going home later today ( Tuesday. Oxygen saturation being low 80’s yesterday w/o supplemental oxygen, they say I need O2 to go home. On the O2 I’m low 90’s. This is upsetting to me but no choice. I was kept bedridden for 5 days which didn’t help. As I’m helpless as I am now if I am better in a few days but still need oxygen I won’t be able to work in my lab/ shop with the oxygen due to fire regulation- devastating. Before last Thursday my O2 was 96-97 and I could do anything physically. Now I feel like I’m in my Now deceased Mothers 88 yr old body.
However, I’m while the infection is cleared up, I still have fluid in both lungs, inflammation, and coughing up pink stained mucus, so when this clears up in time and with the steroids and oxygen assist, and increasing activity, the need for oxygen should hopefully diminish quickly ( I hope) this depends on whether there was permanent damage caused by this event. I did notice a 1-2% saturation improvement over the past 24 hours even with more congestion and coughing.
Time will tell.

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wishing you a continued recovery

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@davidwrenn

Bob, I'm sorry to hear that you seemed to have suffered another bout of delayed hypersensitivity reactions to your chemo/immuno-oncology regimens which triggered your ARDS (acute respiratory distress syndrome)

ARDS occurs as a result of the disruption of the alveolar-capillary bronchio-alveolar endothelial barrier that allows inflammation associated protein-rich fluids to enters the alveoli, causing pulmonary edema. This interferes with respiratory gas exchange and reduced blood oxygen saturation which in turn reduces oxygen supply to the organs of your body. With impaired cardiac function i.e reduced pumping ability this lowers systemic flow of low oxygenated blood to your organ systems (heart, lungs, kidneys, liver and brain). The hypo-perfusion of your various organ systems triggers additional hypoxia related degradation of their normal functioning.

Lower blood oxygenation may initially cause your symtoms of breathlessness (dypsnea). As your blood oxygen levels continue to drop, you may will experience "air hunger" or the inability to catch your breath. As mentioned above, continued oxygen desaturation triggers a catastrophic cascade of multi-organ failure i.e ARDS.

The most common clinical disorders associated with the development of ARDS include sepsis, pneumonia, aspiration of gastric contents, delayed medication hypersensitivity reactions, and major trauma.

In your case, based on your description of the time line of the onset of your symptoms, I strongly suspect that you've suffered a delayed hypersensitivity reactions to your chemo/immuno-oncology regimens.

There are a number of recent reports in the clinical literature re the development of ARDS due to patients' delayed hypersensitivity reactions to FOLFOX/FOLFIRI, Herceptin, and Keytruda and other PD- L inhibitors which have triggered episosodes of sub-phenotype 2 ARDS, which is characterized by hyperinflammation and hypotension.

It seems your pulmonolgist has a handle on your case and is providing you with appropriate supportive care which should include appropriate ventilatory support (I assume you've had a respiratory therapist involved in your care team) wide spectrum antibiotics to address your pneumonia and generally, a tapering steroid regimen to tamp down your inflammatory reactions and other interventions to manage your body's fluid balance and diuresis.

I'm sure he is doing so in consultation with your oncologist.

I hope you feel better soon. Regardless of how crappy you may feel, any day above ground beats the alternative.

Dave

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My husband is goi g through this as well, breathing issues, heart afib, low BP 🙏🏻❤️

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Relicmeister, I haven't been active on this site lately, but am thinking about you and wondering how you are doing. I pray for the best.

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@stever1

Relicmeister, I haven't been active on this site lately, but am thinking about you and wondering how you are doing. I pray for the best.

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Sorry to share this but unfortunately my father (Bob, aka relicmeister) passed away at the end of October. Many thanks to the all of the kind people on this forum that shared so much information with him--you all empowered him and gave him hope.

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@mjstew

Sorry to share this but unfortunately my father (Bob, aka relicmeister) passed away at the end of October. Many thanks to the all of the kind people on this forum that shared so much information with him--you all empowered him and gave him hope.

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I'm so sorry for you and your family loss!! Many times I wondering about him as well.
Helaine

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@mjstew

Sorry to share this but unfortunately my father (Bob, aka relicmeister) passed away at the end of October. Many thanks to the all of the kind people on this forum that shared so much information with him--you all empowered him and gave him hope.

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This hurts so much... I enjoyed our chats. Such a fighter.... my condolences. I will miss him.

Gary

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@jcrs

I'm so sorry for you and your family loss!! Many times I wondering about him as well.
Helaine

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Thank you, it’s comforting to know he was in your thoughts.

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@mrgvw

This hurts so much... I enjoyed our chats. Such a fighter.... my condolences. I will miss him.

Gary

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He was indeed a fighter and an optimist to the very end. Thank you for being there for him.

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@mjstew

Sorry to share this but unfortunately my father (Bob, aka relicmeister) passed away at the end of October. Many thanks to the all of the kind people on this forum that shared so much information with him--you all empowered him and gave him hope.

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So sorry for your loss, which is also our loss. Your father was generous of his time and energy to share with us a lot of medical information as different issues happened and as he progressed in his quest for good health. He put up a valiant fight, always doing his research and then sharing with us. Each of his posts was educational and supportive. We will miss him.

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@cromme50

So sorry for your loss, which is also our loss. Your father was generous of his time and energy to share with us a lot of medical information as different issues happened and as he progressed in his quest for good health. He put up a valiant fight, always doing his research and then sharing with us. Each of his posts was educational and supportive. We will miss him.

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Thank you for the kind words. He spoke very highly of the support and information he found here, and, I hope that what he shared may help others as they battle this. Please, for anyone battling similar- do not be discouraged by the outcome. He came so close to beating it.

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